| NPI | 1679724827 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRGINIA DALE Owner 360-539-8487 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology |
| Additional Taxonomies | 246ZE0600X Specialist/Technologist, Other, Electroneurodiagnostic |
| Enumeration Date | 2008-10-07 |
| Last Update Date | 2023-04-04 |